Pearls and Pitfalls in head and neck and neuroimaging

504 Pages·45.305 MB·English

by  Aygun N., Shah G.

Pearls and Pitfalls in
HEAD AND NECK AND
NEUROIMAGING
Variants and Other
Difficult Diagnoses

Pearls and Pitfalls in
HEAD AND NECK AND
NEUROIMAGING
Variants and
Other Difficult
Diagnoses
Nafi Aygun
AssociateProfessorofRadiologyandDirectoroftheNeuroradiology
FellowshipProgram,JohnsHopkinsUniversity,Baltimore,MD,USA
Gaurang Shah
AssociateProfessorofRadiology,UniversityofMichiganHealth
System,AnnArbor,MI,USA
Dheeraj Gandhi
ProfessorofRadiology,NeurologyandNeurosurgeryatthe
UniversityofMarylandSchoolofMedicine,Baltimore,MD,USA
UniversityPrintingHouse,Cambridgecb28bs,UnitedKingdom
PublishedintheUnitedStatesofAmericabyCambridgeUniversityPress,NewYork
CambridgeUniversityPressispartoftheUniversityofCambridge.
ItfurtherstheUniversity’smissionbydisseminatingknowledgeinthepursuitof
education,learningandresearchatthehighestinternationallevelsofexcellence.
www.cambridge.org
Informationonthistitle:www.cambridge.org/9781107026643
©CambridgeUniversityPress2013
Thispublicationisincopyright.Subjecttostatutoryexception
andtotheprovisionsofrelevantcollectivelicensingagreements,
noreproductionofanypartmaytakeplacewithoutthewritten
permissionofCambridgeUniversityPress.
Firstpublished2013
PrintedinSpainbyGrafosSA,Artesobrepapel
AcatalogrecordforthispublicationisavailablefromtheBritishLibrary
LibraryofCongressCataloginginPublicationdata
Aygun,Nafi.
Pearlsandpitfallsinheadandneckandneuroimaging/NafiAygun,GaurangShah,
DheerajGandhi.
p.;cm.
Includesbibliographicalreferences.
ISBN978-1-107-02664-3(Hardback)
I. Shah,Gaurang. II. Gandhi,Dheeraj. III. Title.
[DNLM:1. Neuroimaging–methods. 2. CentralNervousSystemDiseases–diagnosis.
3. Diagnosis,Differential. 4. OtorhinolaryngologicDiseases–diagnosis. WL141.5.N47]
RC349.D52
616.8004754–dc23 2013010572
ISBN978-1-107-02664-3Hardback
CambridgeUniversityPresshasnoresponsibilityforthepersistenceoraccuracyof
URLsforexternalorthird-partyinternetwebsitesreferredtointhispublication,
anddoesnotguaranteethatanycontentonsuchwebsitesis,orwillremain,
accurateorappropriate.
..........................................................................................................................
Everyefforthasbeenmadeinpreparingthisbooktoprovideaccurateand
up-to-dateinformationwhichisinaccordwithacceptedstandardsand
practiceatthetimeofpublication.Althoughcasehistoriesaredrawnfrom
actualcases,everyefforthasbeenmadetodisguisetheidentitiesofthe
individualsinvolved.Nevertheless,theauthors,editorsandpublisherscan
makenowarrantiesthattheinformationcontainedhereinistotallyfree
fromerror,notleastbecauseclinicalstandardsareconstantlychanging
throughresearchandregulation.Theauthors,editorsandpublishers
thereforedisclaimallliabilityfordirectorconsequentialdamagesresulting
fromtheuseofmaterialcontainedinthisbook.Readersarestrongly
advisedtopaycarefulattentiontoinformationprovidedbythemanufacturer
ofanydrugsorequipmentthattheyplantouse.
To myparents, Vrindavan andVinu Shah,for their love and support;
mywifeKinnari,fortakingthejourneywithme;andmysonsSharvilandSahil,
for bringing joy into ourlives.
GaurangShah
To Bobby, mybest friend and life partnerand for Shreyaand Diya,
mybeautiful daughters and thelove of my life.
Dheeraj Gandhi

Contents
Preface ix
Section 1 Cerebrovascular diseases Section 4 Infectious diseases
Case 1 Densebasilar artery sign 1 Case 36 Brain abscess 191
Case 2 Global anoxic brain injury 4 Case 37 Neurocysticercosis 194
Case 3 Acuteinfarction 8 Case 38 Tuberculosis 198
Case 4 Vertebral artery dissection 10 Case 39 Creutzfeldt–Jakobdisease 207
Case 5 Subacute infarct 13 Case 40 Herpes encephalitis 210
Case 6 Subarachnoid hemorrhage 17
Case 7 Intracranialaneurysms 21 Section 5 Metabolic and neurodegenerative
Case 8 Giant aneurysms 23
conditions
Case 9 Acuteintracerebral hematoma 26
Case 10 Cerebral amyloidangiopathy 30 Case 41 Wernicke’s encephalopathy 213
Case 11 Primary CNS vasculitis 34
Case 42 Hypertrophicolivarydegeneration 217
Case 12 Reversiblecerebral vasoconstriction
Case 43 Adrenoleukodystrophy 219
syndrome 37
Case 13 Moyamoya disease/syndrome 40
Section 6 Trauma
Case 14 Cortical venous thrombosis 43
Case 15 Developmental venous anomalies 46
Case 44 Mild traumatic brain injury 224
Case 16 Dural arteriovenous fistula 49
Case 45 Isodense subdural hematoma 227
Case 17 Cavernousmalformation 52
Section 7 Miscellaneous
Section 2 Demyelinating and inflammatory
diseases Case 46 Posteriorreversible encephalopathy syndrome 229
Case 47 Late-onsetadult hydrocephalussecondary to
Case 18 Tumefactive demyelinating lesion 55 aqueductalstenosis 232
Case 19 Acute disseminated encephalomyelitis 58 Case 48 Intracranial hypotension 234
Case 20 Progressivemultifocal Case 49 Idiopathic intracranial hypertension 238
leukoencephalopathy 62 Case 50 Rathke’s cleft cyst 240
Case 21 Osmotic myelinolysis 65
Case 22 Neurosarcoidosis 72 Section 8 Artifacts and anatomic variations
Case 51 FLAIR sulcal hyperintensity secondary togeneral
Section 3 Tumors
anesthesia 245
Case 52 Virchow–Robin spaces 250
Case 23 Posteriorfossa masses in children 80
Case 53 Arachnoid granulations 255
Case 24 Low-gradeglioma 92
Case 54 Benign external hydrocephalus 257
Case 25 Diffuse intrinsic pontine glioma 105
Case 55 Pitfalls in CTA 260
Case 26 Pseudoprogression of GBM 109
Case 56 Asymmetric pneumatization of the anterior
Case 27 Pseudoresponse in treatment of GBM 112
clinoid process 264
Case 28 Low-gradeoligodendroglioma 114
Case 29 Primary CNS lymphoma 116
Case 30 Pineal region tumors 125 Section 9 Skull base
Case 31 Intraventricular masses 140
Case 32 Colloid cyst 153 Case 57 Fibrous dysplasiaof skull base 267
Case 33 Primary intraosseousmeningioma 161 Case 58 Sphenoid bonepseudolesion 271
Case 34 Suprasellar meningioma 171 Case 59 Clivallesions 276
Case 35 Pituitary macroadenoma 180 Case 60 Perineuralspread 282
vii
Contents
Section 10 Temporal bone Section 16 Vessels
Case 61 Cochleardysplasia 285 Case 84 Carotid artery dissection 381
Case 62 Labyrinthitis ossificans 289 Case 85 Traumaticarterial injury 384
Case 63 Superior semicircular canal dehiscence 292
Case 64 Fluid entrapment in the petrous apex cells 294
Section 17 Spinal column
Case 65 Acquired cholesteatoma 299
Case 66 Malignantotitis externa 304
Case 86 Craniovertebral junction injuries 387
Case 67 Temporal bone fractures 307
Case 87 Odontoid fractures 390
Case 88 Vertebral compression fractures 398
Section 11 Paranasal sinuses Case 89 Sacral insufficiency fracture 401
Case 90 Paget’s diseaseof the spine 405
Case 68 Allergic fungal sinusitis 310 Case 91 Renal osteodystrophy 409
Case 69 Invasive fungalsinusitis 316 Case 92 Calcific tendinitisof the longus colli 414
Case 70 Spontaneous CSF leaks and sphenoid
cephaloceles 324
Section 18 Intervertebral discs
Case 71 Juvenile nasal angiofibroma 328
Case 93 T2hyperintense disc herniation 419
Section 12 Orbits Case 94 Disc herniation andcord compression 424
Case 95 Postoperativedisc herniation versus postsurgical
Case 72 Idiopathic orbitalpseudotumor 331 scarring 427
Case 73 Optic neuritis 336 Case 96 Degenerativeendplate alterations 430
Section 13 Salivary glands Section 19 Spinal canal contents
Case 74 Intraparotid lymph nodes 342 Case 97 Spinal dysraphism 434
Case 75 Benign mixed tumor 344 Case 98 Tethered spinal cord 445
Case 76 Firstbranchial cleft cyst 350 Case 99 ChiariI malformation 449
Case 100 Spinal vascular malformations 455
Case 101 Cord compression 458
Section 14 Neck
Case 102 Demyelinating/inflammatory spinal
cord lesion 466
Case 77 Nasopharyngeal cysts 354
Case 103 Subacute combineddegeneration 469
Case 78 Cystic nodal metastasis 357
Case 104 Intradural cyst 471
Case 79 Low-flow vascular malformations 360
Case 105 Spinal CSF leaks 475
Case 80 Parapharyngeal masses 364
Case 106 Leptomeningeal drop metastases 478
Section 15 Thyroid and parathyroid
Index 486
Case 81 Third branchial apparatusanomaly 370
Case 82 Parathyroid adenoma 372
Case 83 String sign 378
viii